Plantar fasciitis refers to inflammation of the connective tissue between the heel bone and the toes caused by lack of support in the arch. Patients suffering from this condition usually complain of plantar pain along the entire length of the plantar fasciae as well as where these ligaments attach to the heel bone in the rear foot and to the five metatarsal bones. It is generally localized to an area 1-2 cm distal to the medial calcaneal tuberosity. Sometimes the pain occurs only on the sole and heel of the foot. Patients often report severe pain on the bottoms of their feet in the morning, especially the first steps out of bed. Once the foot limbers up, the pain of plantar fasciitis normally subsides, but it may return after long periods of standing or after getting up from a seated position. The reason for the sharp pain in the morning on taking the first steps, is because while asleep, the foot relaxes and drops. In the morning when the patient sets his/her foot on the floor, the plantar fascia is stretched. Pain can be avoided or minimized by gently stretching or massaging the bottom of the foot before getting out of bed. People with high-arched feet are at risk because the plantar fascia is constantly in a stretched position while flat feet can result in a person pronating as there is very little support at the arch. Other biomechanical factors are tight Achilles tendons, and too much or too little movement in the joints of the foot and ankle....
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